***IMPORTANT LAST MINUTE NEWS***

There will be a protest in front of the Federal Courthouse located at 100 S=
tate Street
in Rochester, NY on Wednesday, August 18, 2004 at noon. This is being done =
to
protest the one year prison sentence handed down to Mark H. Fleischer, MD, =
a pain
management physician and anesthesiologist of Rochester, NY, for a misdemean=
or
conviction for Medicare fraud in the amount of $200.00—a sentence that is n=
ot only
patently unfair given the events that lead up to his prosecution, but is al=
so the key
point of a series of injustices that occurred in his case, leading up to an=
d culminating
in a travesty of justice for everyone involved. There is a doctor who riske=
d everything
to treat our pain going to federal prison— his livelihood in ruins, he and =
his family
devastated emotionally and financially, his reputation shattered—and left b=
ehind are
the 85 patients who were under his care, who are suffering from the sudden,=

unexpected loss of their physician as well as their pain treatment.

I am writing this to try to get as many people as I possibly can to attend =
this protest—
or if you can't get there, to spread the word about it to as many people as=
you
possibly can. It is critically important to all of us who suffer with chron=
ic pain (or have
loved ones that do) because of what will inevitably happen to everybody inv=
olved with
chronic pain and opioid medication if we continue to "ignore" or take no ac=
tion on
issues like this because we feel too overwhelmed or not empowered enough to=
deal
with them. Every time a physician is rendered unable to practice because of=

investigations or prosecutions, it is having a direct effect on all of the =
doctors who
treat chronic pain the same way—causing them to limit, reduce, or restrict =
any
treatment of pain that utilizes opioid medications; and even for some, to r=
etire from it
entirely-- making it that much more difficult for any of us to get the trea=
tment we
need to live without undue suffering. The term "chilling effect" has been c=
oined to
describe this cause and effect or negative feedback process, but whatever w=
ords we
choose to use matters little when it comes down to the reality of what this=
means to
each of our individual lives. It is clear that we are at a point of serious=
crisis in the
treatment of pain in our country. The "consensus" document that some of us =
have
been talking about in recent days (the guidelines written by a panel made u=
p of the
DEA, pain treatment physicians and pain treatment policymakers that was rel=
eased on
8/11/04) is a sign that some of this is beginning to be addressed on a nati=
onal level,
but it is only a small first step in the long journey ahead. A journey that=
involves
translating these guidelines into a workable reality that not only addresse=
s, but
implements the necessary changes that need to be made to the entire system.=


I know there are a lot of strong emotions and mixed feelings surrounding al=
l of what
has gone on with Dr. Fleischer—some of you may have heard about some or all=
of
this already—and this is why I feel that I have to qualify what I am saying=
here while
trying to be as objective as I can in my explanation of things. Partly beca=
use in truth,
there wasn't nearly enough communication between Dr. Fleischer and his pati=
ents
when this happened, which as a natural consequence, lead to a serious degre=
e of
uncertainty and misunderstanding among us. I am trying to explain all of th=
is without
judgment, allegation, or implication—just as a set of factual observations =
based upon
my own (and some other patients') experiences. I myself didn't learn of the=
sentence
until almost two weeks after it was handed down; and it was only when I was=
calling
his office "business as usual" for my upcoming appointment, that I was told=
(and
obviously the shock of this "last minute" notification that informed me, wi=
thout any
leeway of time, that my treatment with him was abruptly over, put me in a r=
eally
difficult position as a patient on daily opioid therapy). There's no manual=
or
guidebook in existence, or set of rules or steps, to follow in a situation =
like this—one
that gives any satisfactory answers as to what to do to meet everybody's ne=
eds, or
how to accomplish this, when involved with a complex and emotionally devast=
ating
situation like this. As a natural consequence of this, some patients feel t=
hat he didn't
do enough for all of us through all this (especially after the sentence was=
handed
down)—that he in effect abandoned us, that it is possible that he cares mor=
e for
himself than he does for his patients, or that he doesn't care about us in =
the manner
in which he could (or should) have. Or, in looking at that the way he and h=
is wife (who
manages the office) reacted to what happened—and at what they chose to do (=
or not
do) in their handling of this, coupled with the legal measures he took (acc=
eptance of
the plea agreement in which he pled guilty to the fraud charge), could be
extrapolated to mean that he must be guilty of at least this much; and poss=
ibly to
even more.

All of this is germane in the context of the events that transpired as the =
result of the
sentence being handed down; and the real effects it is having on his and on=
each of
his patient's individual lives—not losing sight of the fact that in any mea=
sure or
evaluation of what transpired as a result of any given situation, hindsight=
is always
20-20, but in the context of the bigger picture surrounding this case, this=
needs to
be set aside for now. It needs to be dealt with as a secondary issue for no=
w in order
to focus on the greater good of doing what we can to prevent a miscarriage =
of justice
in the case of a physician who like any of us is not perfect and has made m=
istakes,
but is at heart a good man with a great deal of compassion for others and a=
proficient
physician who risked all of this in order to treat our pain. To stand up as=
a united
front, with more in common than not, to do what we can to educate as many p=
eople
as possible about the crisis in pain treatment and to the effects that losi=
ng another
pain management physician has on all of us with chronic pain.

For more information contact Debbie
585-461-5984 or 585-461-5999 (office)
585-223-4838 (home)
Debra031857@... (e-mail)


Thanks for listening and doing what you can to help,

Michele Malone (VT)
sunwolf@...